Alaska led the nation with the highest level of well-being of all states, supplanting North Dakota, which plummeted to 23rd place. West Virginia remains the state with the lowest well-being for the sixth consecutive year.

The 2014 Gallup-Healthways Well-Being Index measures the well-being of Americans in each state based on interviews conducted between January and December, 2014. This year’s index incorporated a range of metrics categorized into five essential elements of well-being: purpose, social, financial, community, and physical. Based on the well-being index, 24/7 Wall St. examined the states with the highest and lowest scores.

Click here to see the happiest states in America

Click here to see the most miserable states in America

While Gallup’s index is based in part on subjective survey measures, the respondents’ perceptions are often closely tied to outcomes. According to Dan Witters, research director of the Gallup-Healthways Well-Being Index, well-being is closely linked to economic indicators and societal outcomes, such as median household income and teen pregnancy rates.

Witters explained that the five essential elements of well-being are interwoven, and a high score in one category can lead to a high score in another. However, this was not guaranteed by any means. All of the 10 happiest states rated better than most in the purpose category, which measures how much residents like their day-to-day lives and how motivated they are to meet their goals. However, in other categories, such as the financial element of well-being, two of the top states overall fared worse than most states.

Physical health, which together with healthy behaviors, was part of the physical element of well-being this year, is an especially important factor contributing to happiness, according to Witters. In fact, examination of healthy behaviors and outcomes measured by government data suggest this is the case.
In states with high well-being scores, residents were less likely to smoke and more likely to exercise regularly. Residents in nine of the happiest states were more likely than most Americans to have an exercise routine of some kind. All but one of the states with the lowest well-being, on the other hand, had more physically inactive residents compared to the national average.

The states with the highest well-being also enjoyed the positive outcomes of healthy behaviors, including lower obesity rates and smaller incidences of other common health problems, while in general the opposite was true for the states with the lowest well-being. High cholesterol, high blood pressure, as well as heart disease-related deaths were all far more common in the states with the lowest well-being.

While money certainly does not buy happiness, financial well-being plays a significant role in happiness. All of the most miserable states had median household incomes far below the national median income of $52,250 in 2013. However, the median household income in only half of the happiest states exceeded the national median income.

The states with the happiest residents also had relatively low unemployment rates, and people reported relatively few days of poor mental health. The unemployment rates in all of the 10 happiest states was less than the national rate of 7.4% in 2013. And nine of these states reported fewer monthly poor mental health days than the national average.

A regional pattern is also evident. According to Witters, while the top and bottom states change regularly from one year to the next, they tend to be in similar parts of the country. Witters said states in New England, the Northern Plains and Mountain West regions, as well as Alaska and Hawaii, generally and regularly report very good well-being. Low well-being, on the other hand, is found “around the Bible Belt…the South and heading north up through the industrial midwest.” Witters described this as “a very consistent pattern.”

“The thing about those southern states,” he said, “that really hurts them is that they do a lousy job taking care of themselves.”

24/7 Wall St. reviewed all 50 U.S. states based on their scores in the Gallup-Healthways 2014 Well-Being Index. Gallup-Healthways calculated a national well-being score as well as one for each state based on interviews conducted between January 2 and December 30, 2014, with a random sample of 176,702 adults. As part of the rank, Gallup combined five separate essential elements of well-being. In addition to the index, 24/7 Wall St. considered data from the U.S. Census Bureau’s 2013 American Community Survey, including median household income, poverty rates, and adult educational attainment rates. From the Bureau of Labor Statistics, we reviewed annual state unemployment rates and median hours worked among, both from 2013. We also reviewed 2013 obesity and teen pregnancy rates from the Centers for Disease Control and Prevention. Incidence of heart disease in 2013 is from the Kaiser Family Foundation. The share of the population with low incomes and low access to healthy food comes from the Department of Agriculture’s Food Environment Atlas. Low access is defined as living more than one mile from a supermarket in an urban area or more than 10 miles from a supermarket in a rural area. We also considered state violent crime rates in 2013 from the FBI’s Uniform Crime Report Program. Lastly, we used 2012 regional price parity from the Bureau of Economic Analysis as a proxy for cost of living. All other data come from the United Health Foundation’s 2014 report “America’s Health Rankings”.

These are the happiest (and most miserable) states in America.